Predictors of left ventricular function deterioration in patients with left bundle branch block and ejection fraction...

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Cardiac resynchronization therapy (CRT) is standard for heart failure with reduced ejection fraction (HFrEF).
• Left bundle branch block (LBBB) is a key indicator for CRT eligibility.
• The natural evolution of left ventricular (LV) function in patients with LBBB and preserved ejection fraction (P-EF) is less understood.

Purpose of the Study:

• To investigate the progression of LV function in patients with LBBB and baseline preserved LVEF (>50%).
• To identify clinical predictors of LVEF deterioration to ≤40% in this specific patient cohort.
• To establish a risk-stratification tool for identifying patients who may benefit from early intervention or CRT.

Main Methods:

• Retrospective analysis of echocardiography laboratory records over 4 years.
• Inclusion criteria: LBBB, baseline LVEF >50%, and follow-up echocardiogram ≥3 months post-baseline.
• Endpoint: LVEF deterioration to ≤40%; analysis of associated clinical variables.

Main Results:

• Forty-nine patients met inclusion criteria; mean follow-up was 13±8.5 months.
• 16% (8 patients) experienced LVEF deterioration to ≤40%.
• History of congestive heart failure (CHF) prior to baseline and LV mass >300 g were significant predictors (P=.004 and P=.015, respectively).

Conclusions:

• Patients with LBBB and preserved LVEF at baseline are at risk for future LVEF decline.
• Prior CHF history and elevated LV mass are key indicators for risk stratification.
• Findings may inform triage strategies for CRT in this population.